Weight is a topic that stirs a lot of emotions, and for good reason. With society constantly bombarding us with images and messages of a single “ideal” body, it can feel impossible to navigate the conversation around weight without feeling inadequate or pressured. In this month’s column, we’re addressing some of the questions that come up when addressing weight fluctuations and subsequent weight loss.
Q: Hello! My hormonal IUD causes significant weight fluctuations, to the point that it’s inconvenient because some of my clothes don’t fit me at the high and low points of those fluctuations. Is there anything I can do diet-wise to keep my weight more consistent while I’m using this birth control method? I’m looking for something that doesn’t involve eating more or less than I’m used to, which I worry could veer into disordered eating territory. Thank you!
A: First off, I want to acknowledge that what you’re experiencing is incredibly frustrating. The combination of trying to maintain weight while dealing with hormonal fluctuations from your IUD can definitely add layers of difficulty to the process. And when those changes seem random or out of your control, it’s easy to feel like you’re stuck.
Hormonal IUDs, like Mirena or Skyla, can cause some users to experience weight fluctuations. However, research on this is a bit mixed. Some studies suggest that hormonal birth control can affect appetite or water retention, while others have found minimal impact on actual weight gain (Baer et al., 2020). The effects vary from person to person, and while it’s not universal, many people notice shifts in weight, especially at the higher or lower ends of their cycle.
If you’re looking to stabilize your weight without dramatically altering how much you eat, consider focusing on how you eat rather than just how much you’re eating. A few strategies could help:
One thing to keep in mind is that achieving weight consistency isn’t about dramatically shifting your eating habits—it’s more about small adjustments that support your body’s natural rhythms and hormonal cycles.
Q: I’ve been trying to lose weight through diet and exercise, and it’s just not working. I probably wouldn’t qualify for an Ozempic prescription, but I could buy it (or something similar) online without one. Is it worth it? I’m just so frustrated.
A: Now, regarding medications like Ozempic (semaglutide), it’s understandable to feel curious about these newer treatments, especially when weight loss feels like a constant struggle. Ozempic is a prescription medication originally designed for type 2 diabetes, but it’s also been approved for weight management in people with obesity or those at risk of obesity (Wilding et al., 2021). It works by affecting appetite hormones to help reduce hunger.
However, it’s important to approach weight-loss medications with caution, especially if you’re considering using them without a doctor’s oversight. Unregulated use of these drugs (or similar alternatives) purchased online can be risky. Without proper medical supervision, you might face unwanted side effects like gastrointestinal issues or more serious health complications. It’s always advisable to talk to a healthcare provider about whether these medications are right for you.
While it may seem like things aren’t moving forward, remember that progress in weight management often comes in fits and starts. Be patient with yourself. Focusing on building habits that support overall health—getting enough sleep, managing stress, and nurturing your relationship with food—will go a long way in creating lasting change.
In short, the combination of a balanced diet, hydration, and mindful eating habits will likely support your weight in a healthier way than turning to weight-loss drugs or extreme dietary changes. And don’t forget: weight is just one part of health. How you feel, how your clothes fit, and how your body functions day-to-day matter just as much!
Q: What can one expect to encounter if someone is to undergo a keto/low fat diet for a few months?
A: Whether you’re aiming for weight loss, better blood sugar control, or simply exploring new dietary patterns, it’s important to approach these diets with a balanced understanding of the potential benefits and challenges.
When you first begin a keto (which is by definition a high-fat diet, not simply low-carb) your body will undergo an adjustment phase. For those following keto, this might mean transitioning from burning carbohydrates for energy to burning fats—an adaptation known as ketosis. During this period, it’s common to experience what’s often called the “keto flu.” Symptoms like fatigue, headache, irritability, and dizziness can occur as your body adjusts. These symptoms typically last about a week, and hydrating well, increasing electrolytes, and getting enough sleep can help alleviate discomfort.
On a low-fat diet, the adjustment may be less noticeable, but some people report initial cravings for fatty foods or feeling a bit hungrier as they adjust to lower calorie density from fats. Over time, however, your body can become accustomed to this shift, leading to more stable energy levels.
After the initial adjustment period, many people on keto diets report feeling more mentally focused and experiencing improved clarity. The shift to ketones (the byproduct of burning fat for energy) as a primary fuel source has been shown to provide a steady energy supply to the brain, potentially improving cognitive function. Research suggests ketones may also have neuroprotective effects, potentially benefiting those with neurological conditions like epilepsy (Gomez et al., 2022). On the other hand, low-fat diets, while often not associated with such drastic shifts in energy, can provide more sustainable weight loss for individuals who struggle with high-fat foods that tend to be more calorie-dense.
Both keto and low-fat diets have been shown to help with weight loss, though they do so in different ways. Keto tends to promote weight loss through ketosis, where fat is broken down into ketones and used for energy, leading to decreased fat storage (Paoli et al., 2013). On a low-fat diet, weight loss can occur through a reduced intake of calories, as fats are calorie-dense and removing them can naturally lead to a reduction in overall calorie consumption. Additionally, low-fat diets have been associated with improved cardiovascular health when followed long-term (Sacks et al., 2009).
However, it’s important to remember that both diets might lead to nutrient deficiencies if not followed mindfully. A keto diet, for example, can be low in fruits, vegetables, and fiber, potentially leading to issues like constipation or micronutrient gaps (such as magnesium, potassium, and B vitamins). A well-rounded approach is key—aim for a variety of nutrient-dense foods to ensure you’re meeting all your nutritional needs.
While keto and low-fat diets can yield short-term benefits, it’s crucial to be aware of the potential long-term dangers of “fad” dieting. Fad diets often promise rapid results but are typically unsustainable and can lead to a cycle of yo-yo dieting, where weight is lost quickly but regained just as easily once the diet is no longer followed. This cycle can have negative effects on metabolism, and research shows that repeated cycles of weight loss and gain can increase the risk of developing conditions like insulin resistance, heart disease, and high blood pressure (Mann et al., 2007).
Ultimately, the most successful approach to dieting—whether you choose keto, low-fat, or another dietary pattern—lies in sustainability and balance. Both diets can offer health benefits when practiced with care, but moderation is key. If you decide to commit to a keto or low-fat diet for a few months, stay in tune with your body, and listen to its signals. Consult with a healthcare provider or registered dietitian who can guide you through this process safely, and remember that lasting health is built on consistency and balance—not on extreme restrictions.
At the end of the day, your body is a remarkable thing, capable of incredible resilience and strength, no matter what size or shape it may be. While managing weight is an important part of overall health, it’s not the only measure of wellness or self-worth. True comfort and confidence come from embracing your body as it is, understanding that health and happiness are about so much more than a number on the scale. Self-love and acceptance are the most powerful tools in our journey to wellness—let’s keep that in mind as we navigate the complexities of our bodies and our lives.
I hope this all helps! Until next time, stay curious, stay cute, stay you, and stay tuned for more from the Dietitian’s Desk!